The Vibrant Soundbridge (VSB) middle ear implant is now a well-accepted and widely utilised treatment option for patients with sensorineural hearing loss unable to use standard hearing aids. However, as a relatively recent addition to the portfolio of implants available to the otologist, there are few reports to date of long-term safety and efficacy. In this paper, the authors report a retrospective review of 122 adult ears (104 patients) that underwent VSB for sensorineural hearing loss using an incus vibroplasty technique. Cases performed for mixed or conductive hearing loss, or using other techniques for conduction of sound (i.e. round window or coupler vibroplasty) were excluded. Examining the whole group, the initial postoperative testing showed an average surgically-induced air-bone gap (ABG) of -2.7dB, though the degree of ABG was different at each frequency and was not found to be statistically significant at the most clinically important 2-4KHz frequencies. This ABG remained stable over time. A minor reduction in high frequency bone conduction (BC) levels was also seen at the initial postoperative stage, but interestingly not at follow-up beyond a year. No significant difference in the age-related deterioration of BC thresholds over time was found between the implanted and non-implanted ear in 82 patients, including a group of 16 patients with the longest follow up (mean 11.1 years, range 8.2-13.9 years). A significant improvement in word recognition scores was seen at all stages of follow-up. These results suggest that inner and middle ear function remain stable following VSB surgery.

Long-term results of incus vibroplasty.
Maier H, Hinze AL, Gerdes T, Busch S, Salcher R, Schwab B, Lenarz T.
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Stuart Burrows

FRCS (ORL-HNS), Wellington Regional Hospital, Newtown, Wellington, New Zealand.

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